Canada is the only country in the world with a universal public health care system that doesn’t include access to prescription medication. This leaves 1 in 10 Canadians unable to afford prescribed medications. A national drug plan must be public, universal and safe providing everyone with the medications they need. Recent research has shown that this could save the Federal government as much as $11B annually.
In many cases, Canadians requiring medication face impossible decisions, like purchasing their drugs or putting food on the table. Those who are able to fill their prescriptions often need to rely on insurance or constant, careful saving. These prescriptions – ranging from cancer treatments to insulin to antibiotics – are fundamental to our healthcare, and the lack of a national drug plan puts our collective health in serious jeopardy.
A national public drug plan is necessary for three reasons: to address the lack of access to prescription drugs under current plans, to control the high price of drugs and to ensure drug safety and proper prescribing practices. Canada needs a national drug plan that is publicly funded and administered, controls costs, provides universal access and ensures the safe and appropriate use of medications.
The CHC is calling for:
- A national public drug plan to be financed by the federal government similar to how hospitals and physicians are paid for.
- Participate in the federal government’s online consultation on pharmacare.
- Get informed by reading our document about the 5 principles of a National Public Drug Plan
- Watch videos from our policy conference on a National Public Drug Plan.
The issue in detail
In the case of prescription drugs, a national program is also necessary in order to reduce prescription drug prices. Negotiations on drug prices need to be at the national level for the whole population in order to wield effective bargaining power and cut down on administrative costs. National negotiations for a public plan covering all drugs is also the only way to prevent pharmaceutical companies from shifting costs from one plan or group to another.
The public drug plans that currently include approximately 29 percent of the population are a patchwork of different provincial, territorial and federal plans. In some provinces, only seniors, those on social assistance and people suffering from certain illnesses are covered, while in others people pay for drugs based on an income assessment. It is important to bear in mind that those included in public drug plans are not necessarily receiving their drugs free of charge. Often part of the cost must still be paid by the individual through deductibles and co-pays which may create a barrier to obtaining prescription drugs. Different provinces or territories also have different drug lists which leaves access to some medications dependent on where you live. One example of this was put together by journalist Andre Picard, where the same out-of-hospital cancer treatment will cost you $0 in Nunavut; $3,000 in BC; and $20,000 in PEI.
Approximately two-thirds of the population rely on private insurance, provided primarily through a wide-ranging assortment of work-based plans. Thousands of plans provide different levels of coverage at each workplace, sometimes including spouses and children. Since benefit plans are part of negotiations in the work place, workers may also be paying for their drug coverage in the form of lower wages. Since these plans are attached to the work place, they are not reliable. If you change jobs or get laid off, you no longer have coverage through the drug plan. In the case of retirement, only a minority of retirees continue to be covered by their work-based plans. Like the public insurance plans, individuals may still need to pay high deductibles and co-pays. Private insurance plans also have their own approved drug lists which leaves some patients unable to access the drugs they need, especially for newer medication or drugs for rare diseases.
There is an obvious solution to the inability of Canadians to access or afford their medication, we should follow in the footsteps of all the other countries with a universal public health care system and create a national public drug plan. Overall we’d save $11 billion and we’d be able to ensure everyone had access to the medication they need.
5 Principles for a National Public Drug Plan (Canadian Health Coalition, 2018)
Canadians Need a National Public Drug Plan for All (Canadian Health Coalition, 2017)
Mythbuster: A National Public Drug Plan (Canadian Health Coalition, 2017)
Policy and Research Documents
Pharmacare now: Prescription medicine coverage for all Canadians. Report of the Standing Committee on Health (House of Commons, 2018)
Videos from the policy conference A Prescription for Equity (Canadian Health Coalition, 2017)
A National Drug Plan For All (Policy Paper) (Canadian Health Coalition, 2016)
Down the Drain: How Canada Has Wasted $62 Billion Health Care Dollars without Pharmacare (Hugh MacKenzie for CFNU, 2016)
A Roadmap to a Rational Pharmacare Policy (Dr. Marc-André Gagnon for CFNU, 2014)
The Economic Case for Universal Pharmacare (Dr. Marc-André Gagnon and Guillaume Hébert for CCPA and INRS, 2010)
Life before Pharmacare (CHC and CCPA, 2008)
Submission to the Patented Medicine Prices Review Board (Canadian Health Coalition, 2016)
Rejoinder to the testimony at the Standing Committee on Health of the Parliament of Canada by Innovative Medicines Canada and The Canadian Life and Health Insurance Association Regarding the Development of a National Pharmacare Program (Canadian Health Coalition, 2017)
Rejoinder to the brief submitted by Best Medicines Coalition to the HESA Committee on October 18, 2017. (Independent Voices for Safe and Effective Drugs (IVSED) and Canadian Health Coalition, 2017)